Chiropractic and Chest Pain (Angina Pectoris)

The term “angina pectoris” refers to chest pain. Angina is classified
into three groups: 1. Stable angina (or, “effort angina”); 2. Unstable
angina (“crescendo angina”); and 3. Microvascular angina (“syndrome X
angina”). The 3rd type is caused by narrowing of the tiny blood vessles
supplying the heart muscle and the symptoms vary, making it less easy to
identify, but the good news is that it’s usually easy to treat and not
fatal. Stable or effort angina refers to the more common type of chest
pain related to myocardial ischemia (starving the heart muscle of blood
and therefore, oxygen). This type is brought on by some form of activity
like running or walking with slight or no symptoms noted at rest. This
type responds quickly to the use of nitroglycerine under the tongue, and
symptoms usually only last a few minutes after discontinuing the
activity and reoccurs when activity resumes. It can continue for a long
time but may never progress into unstable angina, which is then treated
surgically, often emergently.

The American Heart Association has
reported that >6 million Americans have angina pectoris. Typically,
because this symptom is quite alarming to the patient, running to a
chiropractor for chest pain is appropriately NOT
the first course of action, as this symptom is considered a sign of
heart disease and indicates an increase risk exists of suffering a heart
attack or cardiac arrest. Therefore, AFTER the
patient is properly diagnosed and initially medically managed, a patient
may elect to seek chiropractic care as benefits have been reported.

A
Danish study published in the Journal of Manipulative and Physiological
Therapeutics (November 2005) reported that patients with the stable
angina may benefit from a four-week course of chiropractic care, though
the authors appropriately caution the reader that further studies are
needed to verity their findings and to not discontinue cardiology care.
In this study, the researchers recruited 275 patients with known or
suspected stable angina. Of this group, 50 were found to have
“cervicothoracic angina,” (CTA) or chest pain arising from the neck or
midback spinal region, and were considered the experimental group and
the others were considered the control group and not treated. The 50
treated patients received eight chiropractic treatments over four weeks
with at least one adjustment (thrust) to the neck and/or mid-back by the
same chiropractor as well as trigger point therapy (deep pressure over
tight muscles). Each patient was evaluated at the start and at the end
of the eight sessions with questionnaires completed concerning the
present intensity of chest, shoulder, arm, and/or spine pain. A second
questionnaire measured the patient’s physical and mental status
assessing their quality of life. At the end of the eight sessions, the
subjects were also asked if they felt better, no change, or worse
compared with when they started care and if they thought the treatment
was beneficial. The results showed that approximately 70% of the CTA
group reported improvement in chest pain and general health.
Specifically, in comparing the CTA vs. the control group: 26% vs. 5% =
“better”; 42% vs. 16% = “a little better;” and 24% vs. 67% = “no
change.” Moreover, no one
in the CTA treated group reported “a little worse” or “worse” vs. the
control group which included 13% and 2%, respectively. When asked
directly, 96% of the CTA treated group reported that chiropractic
treatment had been beneficial. Also, ONLY the CTA treated group showed
quality of life improvement. This study supports that coordinated care
between a chiropractor and the cardiologist can significantly improve
the quality of life for the stable angina pectoris patient.

Members of ChiroTrust® have taken “The ChiroTrust Pledge”: “To the best of my ability, I agree to provide my patients convenient, affordable, and mainstream Chiropractic care. I will not use unnecessary long-term treatment plans and/or therapies.”

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This information should not be substituted for medical or chiropractic advice. Any and all health care concerns, decisions, and actions must be done through the advice and counsel of a health care professional who is familiar with your updated medical history.